| National Provider Identifier [NPI]: | 1689601635 |
| Last Name Of The Provider | SEBAG |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D., FACS, FRCOPHTH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7677 CENTER AVE |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | HUNTINGTON BEACH |
| Zip Code Of The Provider | 926473074 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 16275 |
| Number Of Medicare Beneficiaries | 652 |
| Total Submitted Charge Amount | 8530799.88 |
| Total Medicare Allowed Amount | 3952681.23 |
| Total Medicare Payment Amount | 3080756.5 |
| Total Medicare Standardized Payment Amount | 2845389.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 6861 |
| Number Of Medicare Beneficiaries With Drug Services | 349 |
| Total Drug Submitted ChargeAmount | 5234524.88 |
| Total Drug Medicare AllowedAmount | 2846963.18 |
| Total Drug Medicare PaymentAmount | 2231753.07 |
| Total Drug Medicare Standardized Payment Amount | 2231753.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 9414 |
| Number Of Medicare Beneficiaries With Medical Services | 605 |
| Total Medical Submitted Charge Amount | 3296275 |
| Total Medical Medicare Allowed Amount | 1105718.05 |
| Total Medical Medicare Payment Amount | 849003.43 |
| Total Medical Medicare Standardized Payment Amount | 613636.8 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 265 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 330 |
| Number Of Male Beneficiaries | 322 |
| Number Of Non Hispanic White Beneficiaries | 398 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 187 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4675 |